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SITE ADDRESS <br />LOT NO. <br />F� :RMIT APPLICATI.. N <br />CITY OF EVERET'T PERMIT SERVICES <br />3200 CEDAR STREET, EVERGTT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PARCEL TAX I.D. # <br />BLOCK I TRACT OR SUBDIVISION # <br />�$CC N�IGK- CO^�T K^�TOR-S <br />CONTR. LICENSE # <br />l��C.ci�cs io� mn.- <br />USE OF BUILDING <br />-5-1 a <br />PERMIT # <br />n�ua-i-� <br />7 32U E-1.+C� H ��N 4� l�2 ��leiie.rT ,.�f-1 <br />CONTACT FOR PERMIT PHONE <br />WORK DESCRIPTION <br />�Ll CO CA�Ttnt� �'"l A S I`�� C'-TC iZ- <br />NO. I TYPE OF FIXTURE OR ITEM <br />Toile� <br />�a�htub <br />Lavatory (wash basin) <br />Shower <br />Kilchen sink & disposa' <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barhnop/etc.) <br />Dackflow prevenler <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease Irap <br />Roof drains <br />Other <br />013UX L$7�( `'��T�ur rn�i. <br />KZRKUrN v�/A <br />HEAT SOURCE <br />Elechic _ Gas _ Other <br />Ciac = <br />CONTRACT PRICE OF WORK <br />OOC <br />N0. I TYPE OF FIXTURE OR ITEM <br />AIC — air ha�dling units <br />Forced air systems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Re(rigeration <br />Woodstove <br />Other �Loc.trc Ginr <br />�.neTelt <br />CITY OF [VERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cer;ify Iliat I have read and examined lliis application and know the same to be irue and correct. All provisions of faws and <br />ordinances governing lhis rype of work will be complied with whether specified herein or not. The granling of a permit does nol presume <br />to give aulhority to violate or cancel Ihe provision of any other stale or local law regulating construction or Ihe periormance of <br />cons�ruction. That I am authorized by the owner of tliis property to perform lhe work forwhich application is made and I compiy wilh the <br />Stale Conir�etors Law 18.27 RCW and 2�JG200 WAC. <br />✓ � r � � <br />� �/- /,S <br />.._ - _ ��. �, ..?� «c...-.s-� �'r _ <br />